USPSTF Says Screen Women With Higher Risk for BRCA Mutations

The U.S. Preventive Services Task Force (USPSTF) recommends screening for women at increased risk for carrying a BRCA1/2mutation as well as genetic counseling and testing as indicated for those screening positive. These recommendations form the basis of a draft recommendation statement published online Feb. 19 by the USPSTF.

Heidi D. Nelson, M.D., M.P.H., from the Oregon Health & Science University in Portland, and colleagues updated the 2013 USPSTF review on the benefits and harms of risk assessment, genetic counseling, and genetic testing for BRCA1/2-related cancer in women.

Using BRCA1/2 mutation testing or clinical risk criteria as reference standards, the researchers found familial risk models have moderate-to-high accuracy for guiding referrals to genetic counseling. Genetic counseling can reduce breast cancer worry, anxiety, and depression and increase understanding of risk. Based on these findings, the USPSTF recommends screening for women who have family members with breast, ovarian, tubal, or peritoneal cancer or women with an ethnicity or ancestry associated with BRCA1/2 gene mutations. Genetic counseling and, if indicated, genetic testing should be provided to women with positive screening results (B recommendation). Women whose family or personal history or ethnicity or ancestry is not associated with an increased risk for potentially harmful mutations in BRCA1/2genes should not undergo routine screening, genetic counseling, or genetic testing (D recommendation).

The draft recommendation statement and evidence review are available for public comment from Feb. 19 to March 18, 2019.

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